JERRY LEE TODD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****19

License Status

NOT RENEWED

Business

First Name

JERRY LEE

Last Name

TODD

Suffix

DDS

Business Name

JERRY LEE TODD DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

DECATUR

State

Zip

62525

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005